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Enrollment Eligibility Form (Use only if enrolling in a diabetes plan or program) Company name: Enrolled last name: Enrolled date of birth (MM/DD/YYY): Enrolled first name: Enrolled is (circle): Male
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Provide the necessary information about your current employment, including your job title, department, and work schedule.
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Who needs apwu enrollment dept form:

01
Employees of the American Postal Workers Union (APWU) who wish to enroll in the APWU health insurance program.
02
Individuals who want to apply for health coverage through the APWU and meet the eligibility requirements.
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APWU members who want to make changes to their existing health insurance coverage or add new dependents to their plan.
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The APWU Enrollment Department Form is a document used by the American Postal Workers Union (APWU) to enroll new members into the union.
New members who wish to join the American Postal Workers Union (APWU) are required to file the APWU Enrollment Department Form.
To fill out the APWU Enrollment Department Form, applicants need to provide personal information such as their name, contact details, work information, and payment method. They also need to sign the form to acknowledge their consent to join the APWU.
The purpose of the APWU Enrollment Department Form is to officially enroll individuals as members of the American Postal Workers Union (APWU), allowing them to access the benefits, representation, and support provided by the union.
The APWU Enrollment Department Form requires individuals to provide their full name, mailing address, email address, contact number, current job title, work location, social security numbers, and payment details for dues.
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